Nutrition in Combat Sports

116 R. Kordi and W.A. Wallace
wrestlers, boxers, and kickboxers, as well as the following groups of athletes should
be vaccinated against HBV. [42 ]
Non-infected athletes living in regions with endemic hepatitis B
Athletes who live in low-endemic region and travel frequently to high-endemic
regions
Athletes who practice first aid in the absence of health care providers, including
coaches
Athletes who are suspected of doping (injecting drug abusers)
Athletes who have other risk factors such as sexual/household contact with
infected persons
Children and adolescents athletes
7.2.6 Testing
The recommendations for testing of athletes for BBI are as follow:
(a) Mandatory testing
According to the statements of the FIMS and WHO, and some other sports medicine
associations, mandatory testing or widespread screening of athletes for BBI is
not recommended because these tests could not be used effectively for prevention,
the costs would be excessive and there are additional legal and ethical issues.[ 3, 5, 8]
However, some combat sports organizations, such as the International Federation
of Associated Wrestling Styles and the International Boxing Federation among
other professional boxing organizations, have now regulated that HIV testing is
compulsory for participants in their sports. In addition, the International Amateur
Boxing Association has recently recommended that an HIV test should be carried
out in pre-participation physical examinations. [6, 38, 43, 44 ]
(b) Voluntary testing
Voluntary testing should be recommended for all high-risk athletes, in the same
way as it is offered to nonathletes (e.g., in the case of having multiple sexual partners
and sexual contacts with at-risk persons). [3 ] Knowledge of athletes infected
with BBI is helpful for several reasons. Effective treatment can be offered to the
infected athletes. Preventive actions can be taken such as modification of patient
behavior or HBV vaccination for people who have sexual or household contact with
patients.[ 3, 10 ]
Some legal and ethical issues can arise when a physician knows that an athlete is
positive for BBI. This information should be confidential. Specific actions to be taken
by the physician will be based on the rules and regulations in each country. However,
the joint statements of FIMS and WHO are helpful in this area (see Box 7.2).
Testing for HIV should be encouraged for athletes who may be at risk and
should be done for any athlete who specifically requests it.